Characteristics of patients diagnosed with pancreatic cancer who access palliative care: An observational study
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Published:2023-05-03
Issue:9
Volume:32
Page:2617-2627
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ISSN:0962-9343
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Container-title:Quality of Life Research
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language:en
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Short-container-title:Qual Life Res
Author:
Khan Nadia N.,Evans Sue M.,Ioannou Liane J.,Pilgrim Charles H. C.,Blanchard Megan,Daveson Barbara,Philip Jennifer,Zalcberg John R.,te Marvelde Luc
Abstract
Abstract
Purpose
Despite the benefits of palliative care (PC) in pancreatic cancer, little is known about patients who access PC. This observational study examines the characteristics of patients with pancreatic cancer at their first episode of PC.
Methods
First-time, specialist PC episodes captured through the Palliative Care Outcomes Collaboration (PCOC), in Victoria, Australia between 2014 and 2020, for pancreatic cancer, were identified. Multivariable logistic regression analyses examined the impact of patient- and service-level characteristics on symptom burden (measured through patient-reported outcome measures and clinician-rated scores) at first PC episode.
Results
Of 2890 eligible episodes, 45% began when the patient was deteriorating and 32% ended in death. High fatigue and appetite-related distress were most common. Generally, increasing age, higher performance status and more recent year of diagnosis predicted lower symptom burden. No significant differences were noted between symptom burden of regional/remote versus major city dwellers; however, only 11% of episodes recorded the patient as a regional/remote resident. A greater proportion of first episodes for non-English-speaking patients began when the patient was unstable, deteriorating or terminal, ended in death and were more likely to be associated with high family/carer problems. Community PC setting predicted high symptom burden, with the exception of pain.
Conclusion
A large proportion of first-time specialist PC episodes in pancreatic cancer begin at a deteriorating phase and end in death, suggesting late access to PC. Timely referrals to community-based specialist PC, access in regional/remote areas, as well as development of culturally diverse support systems require further investigation.
Funder
National Health and Medical Research Council Victorian Cancer Agency Monash University
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
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